Mark S. Peterson

Imaging the spectrum of biliary tract disease

An understanding of underlying biliary pathology and the corresponding subtle changes reflected at imaging can greatly improve imaging accuracy in evaluating the biliary tract. The optimal demonstration of biliary tract imaging findings requires attention to specific imaging and contrast techniques, regardless of the modality used.

Radiologic Diagnosis of Hepatocellular Carcinoma

Substantial recent technologic improvements in CT scanning, US scanning, and MR imaging, together with advances in the understanding of the optimal application of contrast administration techniques, have facilitated advances in radiologic imaging detection for HCC diagnosis. Despite a large number of earlier publications reporting a high sensitivity for imaging detection of HCC, more recent screening studies of large cirrhotic populations confirm that only 37% to 45% of HCC tumor nodules are detected by CT scanning, US scanning, or MR imaging. Future investigation will include efforts to improve the detection of small tumors and to characterize with greater specificity the spectrum of nodular changes that occur with cirrhosis. Although several small series have attempted to characterize cirrhotic nodules by evaluating the relative arterial or portal blood supply, these preliminary results require substantiation with larger series. Continued technologic advances such as multidetector helical CT scanning and new US and MR contrast agents under investigation may improve the imaging characterization of cirrhotic nodules.

Long-term Sonographic Follow-up of Stable Imaging Findings of Multiseptate Gallbladder

Multiseptate gallbladder is a very rare congenital anomaly of the gallbladder characterized by multiple thin septations within the gallbladder lumen. Following its detailed description in 1963 by Simon and Tandon, 1 there have been isolated case reports on this anomaly. 1-3 To our knowledge, no one has reported long-term clinical and radiologic follow-up of an asymptomatic patient with a multiseptate gallbladder. On sonography it is important to distinguish this entity from the pseudomembranous appearance caused by detached mucosa of a gangrenous gallbladder. 4